How much rates vary
Facilitymedian $2,630 · 10th to 90th $617 to $9,120Professionalmedian $1,259 · 10th to 90th $123 to $2,042
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,479.11 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,479.11 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $9,332.54 | Professional | None | $1,479.11 | $1,479.11 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,000.00 | $1,258.93 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $794.33 Typical High $1,230.27 | Professional | 62 · Two surgeons | $630.96 | $794.33 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $199.53 Typical High $316.23 | Professional | 80 · Assistant surgeon | $158.49 | $199.53 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $173.78 Typical High $275.42 | Professional | AS · PA/NP assist | $141.25 | $173.78 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,019.95 Typical High $5,248.07 | Facility | None | $549.54 | $3,019.95 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,513.56 | $2,754.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $3,019.95 Typical High $5,128.61 | Facility | None | $549.54 | $3,019.95 | $5,128.61 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,548.82 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $1,174.90 Typical High $1,584.89 | Professional | None | $107.15 | $1,174.90 | $1,584.89 |
SummaCare Setting Facility Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $1,949.84 | Facility | None | $1,659.59 | $1,737.80 | $1,949.84 |
SummaCare Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $2,344.23 | Professional | None | $1,230.27 | $1,348.96 | $2,344.23 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $3,981.07 | Professional | None | $1,380.38 | $1,737.80 | $3,981.07 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $724.44 Typical High $1,778.28 | Professional | 52 · Reduced service | $724.44 | $724.44 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $707.95 | Professional | 53 · Discontinued | $295.12 | $295.12 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $537.03 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $354.81 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $2,511.89 |
Where Ohio sits
The same service costs 6.6 times more in Alabama than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
AL $18,462KY $2,797
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.